Yale faculty host media roundtable about the opioid crisis
Faculty from Yale’s Schools of Medicine and Public Health and Department of Psychiatry offered members of the media insights into the the opioid crisis in Connecticut — and the importance of accurate reporting about it — at a roundtable discussion on June 13.
The roundtable, held at Yale School of Medicine, was a collaboration between the university, Yale New Haven Health, C-HIT, and CORE, a statewide initiative to address the opioid crisis and stem the rising tide of overdose deaths.
Dr. Gail D’Onofrio, chair of emergency medicine, and Dr. David Fiellin, professor of general medicine, opened the two-hour event by describing the opioid epidemic as “the largest public health crisis that we’re facing.” Fiellin underscored the key role that media play in raising awareness about the topic, and communicating accurate, evidence-based information to the public.
D’Onofrio humanized the issue by sharing images of local victims of opioid overdoses — mostly young, white individuals who lost their lives during the past year — their names, ages, and bios underscoring the tragedy of the epidemic.
Professor of epidemiology Robert Heimer then provided an overview of the problem in Connecticut. He explained that there have been three major opioid epidemics through history: in the 1800s, the 1960s, and today. Now that deaths from opioid prescriptions are declining, deaths from illicit opioids, such as heroin and fentanyl, are on the rise, he explained.
Professor of psychiatry Richard Schottenfeld discussed what he called “the botany of desire” — how opioids affect the brain. He explained that opioids don’t only relieve pain, but also depression and anxiety. Because of the powerful effects on the brain, only about 20% of people who develop addictions to opioids achieve long-term abstinence, he said.
Fiellin returned to the podium to talk about the difference between “beds vs. chairs” — that is, inpatient treatment for opioid users versus outpatient care. He emphasized that outpatient treatment with medications that address cravings for opioids, such as methadone or buprenorphine, are the evidence-based standards of care, and that detox is not treatment.
The next two speakers — Dr. Kate Hawk and Dr. Dan Tobin — discussed overdoses and pain, respectively. Hawk noted that where the overdose reversal medication, naloxone (Narcan), is more widely available, overdose deaths decrease. Tobin made the point that while prescription opioids are commonly used for chronic pain, there is not much evidence that they are effective for that purpose. Opioids are not a “silver bullet” for the widespread problem of pain, which affects one in three Americans, he said.
To conclude, Dr. Jeanette Tetrault addressed the issue of stigma and language. “Words can contribute to stigma, and stigma can limit people from seeking treatment,” she said. Using terms such as “person with opioid use disorder” instead of “addict” is not just a matter of sensitivity or political correctness, she said: Research indicates that language does have a measurable impact on how providers perceive their patients.